Variant-specific effects of GBA1 mutations on dopaminergic neuron proteostasis

Glucocerebrosidase 1 (GBA1) mutations are the most important genetic risk factors for Parkinson's disease (PD). Clinically, mild (e.g., p.N370S) and severe (e.g., p.L444P and p.D409H) GBA1 mutations have different PD phenotypes, with differences in age at disease onset, progression, and the severity of motor and non-motor symptoms. We hypothesize that GBA1 mutations cause the accumulation of α-synuclein by affecting the cross-talk between cellular protein degradation mechanisms, leading to neurodegeneration. Accordingly, we tested whether mild and severe GBA1 mutations differentially affect the degradation of α-synuclein via the ubiquitin-proteasome system (UPS), chaperone-mediated autophagy (CMA), and macroautophagy and differentially cause accumulation and/or release of α-synuclein. Our results demonstrate that endoplasmic reticulum (ER) stress and total ubiquitination rates were significantly increased in cells with severe GBA1 mutations. CMA was found to be defective in induced pluripotent stem cell (iPSC)-derived dopaminergic neurons with mild GBA1 mutations, but not in those with severe GBA1 mutations. When examining macroautophagy, we observed reduced formation of autophagosomes in cells with the N370S and D409H GBA1 mutations and impairments in autophagosome-lysosome fusion in cells with the L444P GBA1 mutation. Accordingly, severe GBA1 mutations were found to trigger the accumulation and release of oligomeric α-synuclein in iPSC-derived dopaminergic neurons, primarily as a result of increased ER stress and defective macroautophagy, while mild GBA1 mutations affected CMA, which is mainly responsible for the degradation of the monomeric form of α-synuclein. Overall, our findings provide new insight into the molecular basis of the clinical variability in PD associated with different GBA1 mutations.

Evaluating the effect of tumor size and sidedness on prognosis in stage 2 colon cancer: a retrospective population study

OBJECTIVE

In this study, we aimed to evaluate the effect of tumor size and tumor sidedness on prognosis in patients with stage 2 colon cancer.

PATIENTS AND METHODS

Data of 501 patients diagnosed with stage 2 colon cancer were evaluated retrospectively. It was evaluated whether the patients' age, gender, tumor differentiation, tumor node metastasis (TNM) stage, overall survival rate, and disease-free survival rate had any correlation with horizontal tumor diameter and tumor sidedness. In the ROC analysis performed to determine the cut-off value for the tumor diameter, which we think will predict survival, no significant results were obtained with maximum sensitivity and specificity. Therefore, the median value of the tumor diameter, which is 5 cm, was accepted as the cut-off value.  Kaplan-Meier method and Cox regression analysis were used for survival analysis and determination of prognostic factors.

RESULTS

When the patients were evaluated in terms of tumor localization, 189 (37.7%) patients had right colon tumors and 312 (62.3%) patients had left colon tumors. There was no statistically significant difference in terms of disease-free survival and overall survival according to tumor localization. When the patients were analyzed by dividing them into two groups according to the horizontal tumor size (<5 cm and ≥5 cm), no statistically significant difference was found between the groups in terms of disease-free survival (DFS) and overall survival (OS) p=0.085, p=0.699, respectively.

CONCLUSIONS

Our results suggest that the management of patients with stage 2 colon cancer requires a better understanding of tumor biology rather than features such as tumor size and localization.

Prognostic role of pre-operative serum ferritin level in stage 2 colon cancer

OBJECTIVE

In this study, we aimed to evaluate the prognostic value of preoperative serum ferritin level in patients with stage 2 colon cancer who underwent curative surgery.

PATIENTS AND METHODS

The data of 120 patients who were stage 2 after curative surgery and whose ferritin levels were measured at the time of diagnosis without starting any treatment were analyzed. Demographic data such as age and gender, histopathological characteristics such as tumor size, lymphovascular invasion (LVI), perineural invasion (PNI), number of removed lymph nodes, tumor grade, and clinical and laboratory data were retrieved from the hospital medical charts or electronic medical records. In the survival analysis, the cut-off level of ferritin was accepted as 150 ng/ml, which is the upper limit determined by the World Health Organization (WHO), as a prognostic factor.

RESULTS

Fifty (41.7%) of the patients were female, 70 (58.3%) were male, and the median age was 63.5 (range 24-90) years. There was no significant difference between the low and high ferritin groups regarding age, gender, T stage, tumor localization, histological subtype, PNI, LVI, removal of less than 12 lymph nodes, and tumor size. Disease-free survival and overall survival of patients with high ferritin levels were worse than patients with low ferritin levels, but this difference did not reach statistical significance.

CONCLUSIONS

Serum ferritin level is an easily monitored, cost-effective, and reproducible marker. İn this study we found that high ferritin level was associated with poor survival, although it was not statistically significant.

Villous Adenoma Arising in the Urethra of a Female with Bladder Augmentation History: A Case Report and Review of the Literature

Villous adenomas (VAs) in the female urethra are rare with only seven cases in the English literature to our knowledge. In patients with bladder augmentation cystoplasty, the neoplasia development risk increases and most of these develop in the neobladder or anastomosis line. Only two cases of VA developing from the native bladder mucosa have been reported. Physical examination of a 76-year-old female who had a history of augmentation cystoplasty revealed a caruncula-like structure protruding from the urethral meatus. The urinary USG showed that the lesion had no relation with the bladder. The lesion was excised. Microscopically, it consisted of villous structures covered with pseudostratified intestinal type epithelium. Low-grade dysplasia was present in the epithelium but high-grade dysplasia or in-situ/invasive carcinoma was not observed. Immunohistochemical study showed positivity for CK7, CK20, EMA, CEA and CDX2. The case was reported as VA of the urethra. We presented the first VA case arising in the urethra of a female patient with intestinal bladder augmentation. Excision is curative for pure VAs. Transformation to carcinoma or recurrence has not been reported. However, in one third of the cases, a malignant tumor may accompany the lesion. Therefore, all excision material should be examined carefully. Routine endoscopic follow-up should be performed in cases with bladder augmentation.

Prediction of Benign and Malignant Solid Renal Masses: Machine Learning-Based CT Texture Analysis

RATIONALE AND OBJECTIVES

This study aimed to investigate whether benign and malignant renal solid masses could be distinguished through machine learning (ML)-based computed tomography (CT) texture analysis.

MATERIALS AND METHODS

Seventy-nine patients with 84 solid renal masses (21 benign; 63 malignant) from a single center were included in this retrospective study. Malignant masses included common renal cell carcinoma (RCC) subtypes: clear cell RCC, papillary cell RCC, and chromophobe RCC. Benign masses are represented by oncocytomas and fat-poor angiomyolipomas. Following preprocessing steps, a total of 271 texture features were extracted from unenhanced and contrast-enhanced CT images. Dimension reduction was done with a reliability analysis and then with a feature selection algorithm. A nested-approach was used for feature selection, model optimization, and validation. Eight ML algorithms were used for the classifications: decision tree, locally weighted learning, k-nearest neighbors, naive Bayes, logistic regression, support vector machine, neural network, and random forest.

RESULTS

The number of features with good reproducibility was 198 for unenhanced CT and 244 for contrast-enhanced CT. Random forest algorithm demonstrated the best predictive performance using five selected contrast-enhanced CT texture features. The accuracy and area under the curve metrics were 90.5% and 0.915, respectively. Having eliminated the highly collinear features from the analysis, the accuracy and area under the curve values slightly increased to 91.7% and 0.916, respectively.

CONCLUSION

ML-based contrast-enhanced CT texture analysis might be a potential method for distinguishing benign and malignant solid renal masses with satisfactory performance.

Do the trace elements play a role in the etiopathogenesis of developmental dysplasia of hip?

OBJECTIVE

Alterations in the connective tissue of the hip joint capsule and ligaments might account for the increased laxity seen in patients with developmental dysplasia of the hip. The tensile features of the connective tissue depend on collagen. A number of prior studies have noted the association between the trace elements and collagen biosynthesis. The aim of this research is to determine whether there exists an association between the trace elements and developmental dysplasia of the hip.

PATIENTS AND METHODS

This investigation included 27 patients with developmental dysplasia of the hip (18 females and nine males; mean age 24.3 ± 6.3 months, range 18–36 months) and 26 healthy controls (15 females and 11 males; mean age 23.8 ± 5.4 months, range 18-36 months). The levels of the serum trace elements in the groups were statistically compared.

RESULTS

The Cu levels of the patients with developmental dysplasia of hip were statistically higher than those of the control group (p<0.05). The Zn, Fe, Mg, and Mn levels of the patients with developmental dysplasia of hip were statistically lower than those of the control group (p<0.05).

CONCLUSIONS

We found an association between developmental dysplasia of the hip and the serum trace element levels. We, therefore, believe that the trace element levels may shed light on the etiopathogenesis of developmental dysplasia of the hip. This work should be supported by future studies concerning the causes of the alterations in the serum trace element levels seen in patients with developmental dysplasia of the hip.

Hypothalamic-pituitary-adrenal axis function in traumatic spinal cord injury-related neuropathic pain: a case-control study

PURPOSE

This study aimed to investigate the hypothalamic-pituitary-adrenal (HPA) axis in spinal cord injury (SCI)-related neuropathic pain (NP) using dynamic adrenocorticotropic hormone (ACTH) stimulation tests.

METHODS

This case-control study was conducted with 22 patients diagnosed with traumatic chronic spinal cord injury (15 with and 7 without neuropathic pain) and ten age- and sex-matched healthy control subjects. Collected data included socio-demographic variables, SCI characteristics, and level of NP using a numeric rating scale (NRS) and the Leeds Assessment of Neuropathic Symptoms and Signs pain scale (LANSS). HPA axis function was measured via low-dose (1 μg) and standard-dose (250 μg) ACTH tests (LDT and SDT, respectively).

RESULTS

No significant differences existed regarding peak cortisol responses or area under the curve (AUC) of cortisol responses between the SCI patients with NP and healthy controls using LDT and SDT. In the SCI patients without pain, cortisol responses were significantly lower than those in the healthy controls for LDT and SDT. Peak cortisol and AUC responses of the LDT and SDT were positively correlated with NRS in SCI patients with NP.

CONCLUSIONS

This study demonstrated that, in chronic SCI patients with NP, basal cortisol levels are relatively higher compared to healthy controls, and that HPA axis can be activated with low- and standard-dose ACTH stimulation tests. Although NP following SCI was not significantly associated with hypo- or hypercortisolemia, either after low- or standard-dose ACTH stimulation test, the severity of NP during chronic SCI may be positively associated with HPA axis activity.

Oxidative DNA Damage Is Increased in Living Kidney Donors

BACKGROUND

Long-term consequences of donor nephrectomy might be reduced kidney function, increased risk for cardiovascular disease, and impaired quality of life. The purpose of the current cross-sectional study was to evaluate the relationship between clinical, laboratory, and donation-specific outcomes of living kidney donors and systemic oxidative DNA damage.

METHODS

We conducted a cross-sectional study and assessed retrospectively pre- and postdonation data from 60 donors who donated between 2010 and 2015. Plasma malondialdehyde levels and 8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio) were determined as oxidative stress markers. Catalase, carbonic anhydrase, and paraoxonase (PON) activities were measured as antioxidants.

RESULTS

Approximately 3 years after donation, the hypertensive donor ratio was 12%, and 11% of the donors had glomerular filtration rate <60 mL/min/1.73 m². Mean serum urea (P = .001) and serum creatinine levels (P = .001) were increased; creatinine clearance level (126.2 ± 35.5 vs 94.6 ± 26.8, P = .001) was decreased in the postdonation period. There was a significant positive correlation between predonation serum urea and 8-0HdG/dG ratio (r = 0.338, P = .016) and predonation serum creatinine and 8-0HdG/dG ratio (r = 0.442, P = .001), while there was a significant negative correlation between serum creatinine and PON activity (r = -0.545, P < .001).

CONCLUSION

Our data have demonstrated that kidney donors exhibit increased oxidative DNA damage and decreased antioxidant activity. We propose that predonation serum creatinine is positively correlated with 8-0HdG/dG ratio and negatively correlated with antioxidant PON activity. This is the first study to demonstrate that plasma oxidative DNA damage increases in healthy kidney donors.

Prognostic value of aldehyde dehydrogenase 1 (ALDH1) in invasive breast carcinomas

Aldehyde dehydrogenase 1 (ALDH1) has been identified as a marker of cancer stem cells in breast cancer (BC). Recent studies showed that ALDH1 expression is correlated with poor prognostic parameters and worse clinical outcome in BC. We evaluated ALDH1 expression by immunohistochemistry in a series of 217 invasive BCs and investigated the correlation between ALDH1 expression and clinicopathological parameters, molecular subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 [HER2] type, and triple-negative BC [TNBC]), and patient survival. There was a significant association between ALDH1 expression and tumor grade (p < 0.001), i.e., the expression of ALDH1 was higher in high-grade tumors. ALDH1 expression was significantly associated with estrogen and progesterone receptor (ER and PR) negativity (p < 0.001) and HER2 positivity (p = 0.001). ALDH1 expression ratios were higher in HER2 type and TNBC. There was a statistically significant correlation between ALDH1 negativity and luminal A subtype (p < 0.001). The overall and disease free survival were shorter in ALDH1+ tumors, although without statistical significance. We confirm that ALDH1 is a potentially important, poor prognostic factor in BC, associated with high histological grade, ER/PR negativity and HER2 positivity. For more accurate results, ALDH1 expression should be evaluated in larger case series including various types/subtypes of BC.

Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes

PURPOSE

In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.

METHODS

This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.

RESULTS

Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.

CONCLUSIONS

Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.

What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts

OBJECTIVE

There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories.

MATERIAL AND METHOD

In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire.

RESULTS

The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers.

CONCLUSION

There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

Serum paraoxonase activity and oxidative stress levels in patients with cutaneous anthrax

INTRODUCTION

Anthrax is a bacterial disease caused by the aerobic sporeforming bacterium Bacillus anthracis. It has been suggested that oxidative stress plays an important role in the pathogenesis of B. anthracis. The aim of this study was to investigate serum paraoxonase 1 (PON1) activity, catalase activity, malondialdehyde (MDA) levels, and superoxide dismutase (SOD) levels in patients with cutaneous anthrax.

MATERIALS AND METHODS

Fifteen patients with cutaneous anthrax and 15 healthy controls were enrolled in this study. The serum MDA levels, SOD levels, paraoxonase, arylesterase, and catalase activities were measured using a spectrophotometer.

RESULTS

The serum SOD levels, paraoxonase, arylesterase, and catalase activities were significantly lower in patients with cutaneous anthrax than in controls (for all, p < 0.001), whereas MDA levels were significantly higher ( p < 0.001). No significant correlation was found between serum paraoxonase activity, arylesterase activity, SOD levels, and MDA levels (all, p > 0.05) in patients with cutaneous anthrax.

CONCLUSIONS

The current study was the first to show decreased antioxidant levels and increased oxidant levels in patients with cutaneous anthrax. Therefore, decreased PON1 activity may play a role in the pathogenesis of cutaneous anthrax.

Acute intestinal obstruction due to a non-involuted uterus after cesarean section: case report

The involution of the uterus is influenced by a number of factors such as advanced childbearing age, electrolyte disturbances, multiparity, repeated cesarean sections, and vaginal infections. The authors report the management of a clinical case of a 41-year-old female who presented with acute intestinal obstruction due to a non-involuted uterus after cesarean section.

The activities of serum paraoxonase and arylesterase and lipid profile in acute myeloid leukemia: preliminary results

OBJECTIVE

To investigate the activities of serum paraoxonase-1 (PON1) and arylesterase (ARE), and the lipid profile in newly diagnosed acute myeloid leukemia (AML) patients.

PATIENTS AND METHODS

Thirty-two persons (16 of AML and 16 of healthy control) were included to the study. PON1 and ARE activities were measured as spectrophotometrically in serum samples. High density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC), triglyceride (TG) were analyzed in autoanalyzer.

RESULTS

PON1 activities were respectively 16.04 U/L and 18.6 U/L in AML and healthy controls. There was no statistical significance between groups (p > 0.05). The mean ARE activities were respectively 0.21 U/L and 0.36 U/L in AML and healthy controls. Serum ARE activity significantly decreased in AML group (p < 0.001). Serum HDL values were significantly decreased (181.8 ± 76.2 mg/dl; p = 0.002) in AML. There was no difference in total cholesterol, LDL and triglyceride values (respectively; 181.8 ± 76.2 mg/dl, 120.6 ± 64.6 mg/dl, 157.3 ± 87.2 mg/dl; p > 0.05) between AML and controls.

CONCLUSIONS

This is the first documented study about serum PON1 activity in AML patients. Although serum PON1 activities were not changed in both groups, our data suggest that the decreased serum ARE activity and HDL levels may be related the pathogenesis of AML.

Staging and evaluation of neoadjuvant chemotherapy response with ¹⁸F-FDG PET/CT in NUT-midline carcinoma in a child: a case report and review of the literature

NUT midline carcinoma (NMC) is a newly defined and lethal cancer with aggressive course. It mostly affects children and young adults. Diagnosis is confirmed with the evidence of BRD4-NUT mutation on the chromosome 15q14 by fluorescence in situ hybridization. Use of (18)F-FDG PET/CT in NMC patients is very limited in the literature. In this report, we describe a 7-year-old boy with the diagnosis of NMC who was scanned with (18)F-FDG PET/CT for staging and treatment response evaluation after the chemotherapy. It was disseminated and had moderate FDG avidity in the initial scan and showed progression after 4 cycles of chemotherapy. We also reviewed the literature related to (18)F-FDG PET/CT in staging and assessment of chemotherapy response of NMC.

Acetaminophen intoxication is associated with decreased serum paraoxonase and arylesterase activities and increased lipid hydroperoxide levels

BACKGROUND

Acetaminophen is at present one of the most commonly used analgesics and antipyretics. Recent evidence has suggested that oxidative stress is involved in the mechanism of acetaminophen intoxication. Paraoxonase-1 (PON1) plays an important role as an endogenous free-radical scavenging molecule. The aim of this study was to evaluate the influence of serum PON1 activity and oxidative stress in patients with acetaminophen intoxication.

METHODS

A total of 20 patients with acetaminophen intoxication and 25 healthy controls were enrolled. Serum total antioxidant capacity (TAC), lipid hydroperoxide (LOOH) levels, and paraoxonase and arylesterase activities were measured spectrophotometrically.

RESULTS

The serum TAC levels and the paraoxonase and arylesterase activities were significantly lower in patients with acetaminophen intoxication compared with controls (all, p < 0.001), while the serum LOOH levels were significantly higher (p < 0.001).

CONCLUSIONS

Our results suggest that decreased PON1 activity seems to be associated with increased oxidative stress in patients with acetaminophen intoxication. Measuring serum PON1 activity may be useful in assessing the development of toxicity risk in acetaminophen toxicity. It would be useful to recommend vitamins with antioxidant effects such as vitamins C and E along with medical treatments.

Effects of 900 MHz electromagnetic field emitted by cellular phones on electrocardiograms of guinea pigs

This study was carried out to determine the effects of electromagnetic field (EMF) emitted by cellular phones (CPs) on electrocardiograms (ECGs) of guinea pigs. A total of 30 healthy guinea pigs weighing 500-800 g were used. After 1 week of adaptation period, animals were randomly divided into two groups: control group (n = 10) and EMF-exposed group (n = 20). Control guinea pigs were housed in a separate room without exposing them to EMFs of CPs. Animals in second group were exposed to 890-915 MHz EMF (217 Hz of pulse rate, 2 W of maximum peak power and 0.95 wt kg(-1) of specific absorption rate) for 12 h day(-1) (11 h 45 min stand-by and 15 min speaking mode) for 30 days. ECGs of guinea pigs in both the groups were recorded by a direct writing electrocardiograph at the beginning and 10th, 20th and 30th days of the experiment. All ECGs were standardized at 1 mV = 10 mm and with a chart speed of 50 mm sec(-1). Leads I, II, III, lead augmented vector right (aVR), lead augmented vector left (aVL) and lead augmented vector foot (aVF) were recorded. The durations and amplitudes of waves on the trace were measured in lead II. The data were expressed as mean with SEM. It was found that 12 h day(-1) EMF exposure for 30 days did not have any significant effects on ECG findings of guinea pigs. However, this issue needed to be further investigated in a variety of perspectives, such as longer duration of exposure to be able to elucidate the effects of mobile phone-induced EMFs on cardiovascular functions.

Gamma probe guided surgery for osteoid osteoma: is there any additive value of quantitative bone scintigraphy?

OBJECTIVE

The aim of this study is to evaluate the efficiency of gamma probe guided osteoid osteoma surgery and the applicability of quantitative analyses obtained from preoperative bone scan images.

MATERIAL AND METHODS

This study involved 12 osteoid osteoma patients who were treated with gamma probe guided surgery after preoperative bone scan. The calculated contrast ratios between nidus and adjacent healthy bone from preoperative bone scan and the calculated percentages of count reduction after resection of nidus during intraoperative gamma probe application were compared. Patients were followed up for any recurrence or complications.

RESULTS

The mean contrast ratio between nidus and adjacent healthy bone calculated from preoperative bone scan was 43.6% (range 33-53%). Following the nidus excision, an average of 55.8% (range 28-73%) count reduction was estimated with gamma probe in the tumor area. There was no correlation between preoperative scintigraphic contrast ratio and intraoperative gamma probe count reduction ratio (r = 0.46, p = 0.13). Complete cure was achieved in 11 (92%) patients with single operation, during the postoperative follow up period. None of the patients had any major or minor complications during or after the surgery.

CONCLUSIONS

Due to high clinical success and low complication rate in osteoid osteoma surgery, gamma probe application is an effective and safe method that should be used more extensively in daily practice.

An Unusual Complication following Unconventional Use of High Pressure Injector

High pressure injection injuries most commonly occur in industrial accidents. In accident due to high pressure gun injuries, the nature of injected materials, the degree of toxicity, and the amount injected will affect the clinical outcome. Early vigorous treatment is essential to reduce morbidity. We reported a case of hand injuries due to inadvertent use of a high pressure injector device for haemostasis. 46-year-old male technician tried to stop bleeding from his injured hand by directing air jet from a high pressure injector to the wound resulting in significant subcutaneous emphysema. Adequate training and knowledge on occupational safety should be reinforced to avoid similar accidents.

Short-term levosimendan treatment protects rat testes against oxidative stress

The objective of this study was to evaluate the effect of short-term levosimendan exposure on oxidant/antioxidant status and trace element levels in the testes of rats under physiological conditions. Twenty male Wistar albino rats were randomly divided into two groups of 10 animals each. Group 1 was not exposed to levosimendan and served as control. Levosimendan (12 µg/kg) diluted in 10 mL 0.9% NaCl was administered intraperitoneally to group 2. Animals of both groups were sacrificed after 3 days and their testes were harvested for the determination of changes in tissue oxidant/antioxidant status and trace element levels. Tissue malondialdehyde (MDA) was significantly lower in the levosimendan group (P < 0.001) than in the untreated control group and superoxide dismutase and glutathione peroxidase (GSH-Px) levels were significantly higher in the levosimendan group (P < 0.001). Carbonic anhydrase, catalase and GSH levels were not significantly different from controls. Mg and Zn levels of testes were significantly higher (P < 0.001) and Co, Pb, Cd, Mn, and Cu were significantly lower (P < 0.001) in group 2 compared to group 1. Fe levels were similar for the two groups (P = 0.94). These results suggest that 3-day exposure to levosimendan induced a significant decrease in tissue MDA level, which is a lipid peroxidation product and an indicator of oxidative stress, and a significant increase in the activity of an important number of the enzymes that protect against oxidative stress in rat testes.

Giant multilocular cystadenoma of the prostate: a rare cause of huge cystic pelvic mass

Giant multilocular prostatic cystadenoma is a rare benign tumor that evolves from the prostate gland. Obstructive voiding symptoms occur in all reported cases. These lesions do not invade adjacent structures. Preoperative radiologic evaluation can define the benign nature of the lesion. Here we report a case of large cystic lesions identified by magnetic resonance imaging and sonographic findings that caused an extensive mass effect in the pelvis. When retrovesical, huge cystic lesions fill the pelvis completely in young men, with high levels of serum prostate-specific antigen, giant multilocular prostatic cystadenoma should be considered as a differential diagnosis. To our knowledge, this is the youngest case of prostatic cystadenoma reported in the literature.

Oxidative Stress and Antioxidant Enzyme Activities in Newborns with Oesophageal Atresia and Their Mothers

OBJECTIVE: To measure the oxidant/antioxidant status of newborn babies with oesophageal atresia and their mothers, compared with healthy control subjects. METHODS: This case—control study included 40 participants: 10 newborns with oesophageal atresia and their mothers, and 10 healthy newborns and their mothers. Whole blood malondialdehyde (MDA) levels and the activities of antioxidant enzymes (catalase, carbonic anhydrase [CA], glucose-6-phosphate dehydrogenase [G-6-PD], and superoxide dismutase [SOD]) were measured. RESULTS: MDA levels and CA activity were significantly higher, and catalase, SOD and G-6-PD activities were significantly lower, in newborns with oesophageal atresia and their mothers than in healthy newborns and their mothers. Although CA activity was similar between the newborns and mothers in the patient group, it was significantly lower in newborns than in mothers in the healthy group. CONCLUSIONS: Increased lipid peroxidation might play an important role in the pathogenesis of oesophageal atresia. Impairment of the free radical/antioxidant balance may lead to increased free radical and decreased antioxidant levels in oesophageal atresia.

Serum trace elements and heavy metals in polycystic ovary syndrome

OBJECTIVE

We aimed to investigate the serum levels of essential trace elements copper (Cu), zinc (Zn), manganese (Mn), magnesium (Mg) and heavy metals cadmium (Cd), cobalt (Co) and lead (Pb) in the patients with polycystic ovary syndrome (PCOS).

METHODS

A total of 65 (35 patients with PCOS and 30 healthy controls) women were included in the study. Serum Cu, Zn, Mn, Pb, Mg, Co and Cd levels were analyzed using atomic absorption spectrophotometric method.

RESULTS

Serum Cu and Zn levels were significantly higher, but Mn and Pb levels were lower in patients with PCOS compared with the healthy participants (p < 0.01). There was no difference between patients with PCOS and the controls with respect to the serum levels of Mg, Co and Cd.

CONCLUSIONS

This is the first study investigating serum Cu, Zn, Mn, Pb, Co, Mg and Cd levels in the patients with PCOS. The serum levels of trace elements and heavy metals might change in patients with PCOS. The findings in this study should be investigated with further trials in order to obtain new insights into PCOS.

Control of mushroom sciarid fly Lycoriella ingenua populations with insect growth regulators applied by soil drench

Mushroom sciarid fly Lycoriella ingenua (Dufour, 1839) comb. nov., is one of the most common fly pests affecting the cultivation of Agaricus bisporus (Lange) Imbach in Turkey. In this study, eight insect growth regulators (IGRs)--diflubenzuron, flufenoxuron, lufenuron, methoprene, novaluron, pyriproxyfen, teflubenzuron, and triflumuron-were tested for their potential to control L. ingenua populations in two successive growing periods. Treatments were targeted at larvae as soil drenches; treatment efficacy was evaluated by assessing adult emergence and larval damage. These products were compared with a control treated with water (negative control) and a conventional chemical insecticide (chlorpyrifos ethyl) (positive control). Treatments with the IGRs caused significant reductions in emerging adult numbers and sporophore damage rates compared with the water-treated control over the two growing periods. Of the IGRs tested, novaluron, diflubenzuron, and teflubenzuron had significantly lower numbers of emerging adults than the rest of the IGRs and chlorpyrifos ethyl-treated control in both periods. Treatments with teflubenzuron, pyriproxyfen, novaluron, and diflubenzuron resulted in significantly lower sporophore damage rates than all other treatments. Compared with negative control, there were no significant yield reductions due to applications of selected IGRs. The results suggest that all the IGRs tested can be used as alternatives to conventional pesticides in controlling L. ingenua populations on mushroom.

N-[2-(4-Bromo-phen-yl)-5-methyl-4-oxo-1,3-thia-zolidin-3-yl]pyridine-3-carboxamide

In the title compound, C(16)H(14)BrN(3)O(2)S, the atoms of the 1,3-thia-zolidine group, except for the N and the C atoms attached to the bromo-benzene ring, are disordered over two sets of sites with occupancies of 0.605 (13) and 0.395 (13). The benzene and pyridine rings make a dihedral angle of 86.2 (2)°. In the crystal, mol-ecules are linked by inter-molecular N-H⋯N and C-H⋯O hydrogen bonds, forming a three-dimensional network. Furthermore, there is a π-π stacking inter-action [centroid-centroid distance = 3.758 (2) Å] between the pyridine and benzene rings.

N-[2-(4-Chloro-phen-yl)-5-methyl-4-oxo-1,3-thia-zolidin-3-yl]pyridine-3-carboxamide

The title compound, C₁₆H₁₄ClN₃O₂S, crystallizes with two mol­ecules in the asymmetric unit. In the 1,3-thia­zolidine rings, the carbonyl O atoms, the S atoms, the methyl groups and the ring carbon attached to the methyl groups are disordered with occupancy ratios of 0.509 (7):0.491 (7) in one mol­ecule and 0.464 (14):0.536 (14) in the other. The crystal structure is stabilized by inter­molecular N—H⋯N, C—H⋯O hydrogen bonds and C—H⋯Cl inter­actions. In addition, there is a π–π stacking inter­action [centroid–centroid distance = 3.794 (3) Å] between the benzene and pyridine rings.

N-[5-Methyl-2-(2-nitro-phen-yl)-4-oxo-1,3-thia-zolidin-3-yl]pyridine-3-carboxamide monohydrate

In the title compound, C₁₆H₁₄N₄O₄S·H₂O, the benzene and pyridine rings make a dihedral angle of 85.8 (1)°. Both enanti­omers of the chiral title compound are statistically disordered over the same position in the unit cell. The methyl and carbonyl group attached to the stereogenic center (C₅ of the thia­zolidine ring) were therefore refined with common site-occupation factors of 0.531 (9) and 0.469 (9), respectively, for each stereoisomer. In the crystal, inter­molecular N—H⋯O, O—H⋯O and O—H⋯N hydrogen bonds link the mol­ecules, forming a three-dimensional supra­molecular network. The crystal structure further shows π–π stacking inter­actions [centroid–centroid distance = 3.5063 (13) Å] between the pyridine rings.

Rehabilitation results of patients with acute transverse myelitis

BACKGROUND

In this study, we aimed to evaluate the efficacy of rehabilitation in patients with acute transverse myelitis (ATM).

METHOD

The patients were included in rehabilitation program in the rehabilitation unit. Spasticity of the patients was evaluated by modified Ashworth scale at baseline and at the end of treatment. The functional independence measurement (FIM), Barthel index and functional ambulatory scale (FAS) values were as well evaluated at baseline and at the end of the treatment, and the results were compared to evaluate the efficacy of the rehabilitation program.

RESULTS

A total of 13 patients (6 males, 7 females) with transverse myelitis were included in the study. The mean +/- SD of age of the patients was 14.30 +/- 3.14. The mean +/- SD of duration of disease was 4.5 +/- 1.85 weeks. There was statistically significant difference in modified Ashworth scale, FIM, and FAS values when the baseline and after treatment values were compared, which indicated improvement due to treatment (p < 0.05).

CONCLUSIONS

We concluded that in patients with ATM, rehabilitation of patients contributes to clinical and functional improvement of the disease (Tab. 2, Fig. 1, Ref. 23).

Clinicopathologic and prognostic evaluation of invasive breast carcinoma molecular subtypes and GATA3 expression

PURPOSE

recently, molecular subclassification of breast carcinomas has been proposed as a new prognostic parameter.

METHODS

we classified 222 invasive breast carcinoma cases in 5 molecular subtypes by using tissue microarray (TMA) and immunohistochemistry methods. These subtypes were luminal A (estrogen receptor/ER and/or progesterone receptor/ PR positive), luminal B (ER and/or PR positive + HER2 positive), HER2-expressing type (ER and PR negative, HER2 positive), basal-like type (ER, PR and HER2 negative, positive with at least one of these myoepithelial markers: CK5/6, CK14, EGFR) and null type (ER, PR, HER2 and myoepithelial markers negative). We compared these subtypes according to their clinicopathological features and GATA3 expression.

RESULTS

luminal A was the most frequent subtype. According to overall survival rates, HER2-expressing and basal- like types had the worst prognosis, while luminal A had the best. However, luminal B had the worst prognosis according to disease free survival. Most of the squamous differentiated metaplastic carcinomas were basal-like type. Tubular and mucinous carcinomas were luminal A. Most basal-like tumors were grade III. The majority of grade I tumors were luminal A. GATA3 positivity was associated with low grade tumors and luminal A subtype.

CONCLUSION

molecular classification can be accepted as an independent prognostic factor for invasive breast carcinomas. GATA3 expression was associated with luminal A and low histological grade. However, it wasn't shown as an independent parameter.

Dilated cardiomyopathy in celiac disease: role of carnitine deficiency

Celiac disease (CD) is an immune-mediated enteropathy in genetically susceptible persons and the disease can present with manifestations in the intestine and in organs outside the gut. An increased prevalence of CD in patients with idiopathic dilated cardiomyopathy or secondary cardiomyopathy and some other cardiac disorders has been reported. Here is described a case of dilated cardiomyopathy in a patient with CD and secondary carnitine deficiency. Dilated cardiomyopathy due to carnitine deficiency may occur in CD patients and carnitine deficiency may present not only at the time of diagnosis of CD but it may also develop during gluten-free diet, particularly in patients with fast weight gain and without carnitine supplementation.

The diagnostic utility of maspin in the distinction between malignant mesothelioma and pulmonary adenocarcinoma

Immunohistochemistry is frequently employed to differentiate between malignant mesothelioma (MM) and pulmonary adenocarcinoma (AC) infiltrating the pleura, but there is uncertainty as to which antibodies are most useful. The present study investigated the presence of the serine protease, maspin, in epithelioid MMs and evaluated the diagnostic utility of maspin for the differential diagnosis between epithelioid MM and pulmonary AC with pleural involvement. The results showed more frequent maspin immunostaining among AC cases compared with MM cases. Maspin positivity was significantly higher among AC cases with respect to both the extent and intensity of staining. A significant difference also existed between the two tumour types with respect to the overall maspin score. Despite these findings, the sensitivity and specificity of maspin positivity to detect AC were only 59% and 73%, respectively, indicating that detection of maspin is of no value for the differential diagnosis of AC and MM.

N-[(2S)-2-(4-Bromo-phen-yl)-4-oxo-1,3-thia-zolidin-3-yl]pyridine-3-carboxamide

In the title compound, C₁₅H₁₂BrN₃O₂S, the dihedral angle between the pyridine and benzene rings is 73.17 (19)°. The five-membered 1,3-thia­zolidine ring has an envelope conformation, with the S atom displaced by 0.196 (1) Å from the mean plane of the four other ring atoms. An intra­molecular C—H⋯N inter­action occurs. The crystal structure is stabil­ized by inter­molecular N—H⋯O and C—H⋯O hydrogen bonds and C—H⋯π inter­actions. In addition, a weak π–π stacking inter­action is also observed between the 1,3-thia­zolidine and pyridine rings [centroid–centroid distance = 3.805 (2) Å].